Children's Monitor Online
A Public Policy Update from the Child Welfare League of America

   
   
Vol. 23, Issue 8: 3/8/2010   
Headlines

Possible Way Forward on Health Care

CHIPRA Guidance from CMS Affects FMAP

Early Learning Fund Could Benefit From Health Care Enactment

Congress Moves on Jobs and Safety Net Support

CWLA Joins Effort to Push Juvenile Justice

House Holds Hearing on Federal Child Nutrition Programs

Sparks Confirmed for Administration for Native Americans at HHS

Key Upcoming Dates for Congress



Possible Way Forward on Health Care

With the President announcing his proposed adjustment to the health care reform package there is a great deal of speculation about how the necessary votes will be reached. It is becoming clear that the only way to enact reform is through a two-bill process. The process would require the House to pass what the Senate already passed last December. Changes negotiated between the House and Senate and additions that the President suggested last week would then be incorporated in a House reconciliation bill. The Senate would then take up that reconciliation bill, which could not be filibustered.

Such an approach may also help address some of the earlier hurdles that a single health care reconciliation bill would have created. A single reconciliation could be subject to a number of amendments that would affect key parts of health reform such as prohibitions to ban discrimination by the insurance providers. Generally speaking, Senate rules prohibit a reconciliation bill from including provisions that are not germane to decreasing the deficit or increasing revenue. Under the two-bill scenario, one set of theories circulating in Washington calculated that the process might work like this: The House passes the Senate bill by March 19, the President signs that bill and the House then adopts reconciliation with corrections to that bill by March 21. The Senate then votes on that bill around March 26. There is a limit on how long a bill can be debated in the Senate, but after time has expired there is no limit on amendments even if they cannot be debated. There has been some speculation that the opposition could offer endless numbers of amendments just to drag the time out.

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CHIPRA Guidance from CMS Affects FMAP

On March 2, the Centers for Medicare and Medicaid Services (CMS) issued guidance on sections 114 and 115 of CHIPRA, which are related to the Federal Medicaid Assistance Percentage (FMAP) rate that a state may claim for Children's Health Insurance Program (CHIP) expenditures. The CHIP Reauthorization Act of 2009 (CHIPRA, P.L. 111-3) reauthorized and finances CHIP through FY 2013. It preserves coverage for millions of children who currently rely on CHIP and provides resources for states to reach millions of additional uninsured children.

The guidance clarified that instead of using the enhanced FMAP rate that would otherwise apply to CHIP expenditures, the regular FMAP rate would apply. Note that the current FMAP rate is the increased rate of 6.2% provided for in the ARRA. Section 114 of CHIPRA does provide an exception for states that had existing authority to cover children above 300% of the federal poverty level as of the date of enactment (February 4, 2009). It also clarifies that states have the option to modify their CHIP programs from a separate child health program to a Medicaid expansion program so long as they submit both a CHIP State Plan Amendment (SPA) and a Medicaid SPA at least 45 days prior to the start of a certifying quarter (CMS will accept changes on a quarterly basis).

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Early Learning Fund Could Benefit From Health Care Enactment

Last September the House of Representatives passed the Student Aid and Fiscal Responsibility Act of 2009, H.R. 3221. Although the main focus of the bill is reform of the college loan system, it includes the important Early Learning Challenge Fund. This fund provides resources to better coordinate services and support to very young children. Under the reconciliation instructions adopted in last year's budget resolution, the college loan reform bill was also included along with health care reform. So if the Congress does take up reconciliation, it could also take up the Early Learning Challenge Fund.

The primary goal of the fund is better coordination between and greater funding for Head Start, child care, and state pre-K programs. For details about the bill, see a previous article from Children's Monitor.

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Congress Moves on Jobs and Safety Net Support

On Thursday, the House passed the Senate's $15 billion jobs bill in a 217-201 vote. This bill was the first of two key legislative measures that will provide benefits to struggling Americans and their families. The first package consists primarily of short-term extensions to COBRA health care premium assistance, payment rates to Medicare providers, and unemployment insurance. Senators Max Baucus (D-MT) and Harry Reid (D-NV) introduced the second piece of legislation, the American Workers, State, and Business Relief Act as a substitute amendment to H.R. 4213, the Tax Extenders Act of 2009. This bill, projected to cost roughly $150 billion, will extend loan programs for small businesses and tax cuts that provide the tax certainty families and businesses need to create jobs, and support safety-net programs that families and communities depend on in the tough economic climate. Included in the safety net programs is the much needed extension of the stimulus bill's FMAP rate through June 30, 2011. The Center on Budget Priorities indicates failure to pass "jobs legislation" could very well result in cuts to the Medicaid that would in turn result in hundreds of thousands, and perhaps millions, of uninsured Americans.

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CWLA Joins Effort to Push Juvenile Justice

CWLA joined with other organizations to urge Congress to complete action on juvenile justice legislation. CWLA sent a letter to the entire Senate urging them to take up the bill and pass it as soon as possible. In December the Senate Judiciary Committee passed S. 678, the Juvenile Justice and Delinquency Prevention Act. The next step is for the full Senate to consider the bill.

S. 678 improves and revises key components of the Juvenile Justice and Delinquency Prevention Act (JJDPA) including provisions addressing the significant link between child maltreatment and later involvement with the juvenile justice system. The legislation strengthens measures addressing this linkage in three critical ways. It provides for the compilation of data on juveniles entering the juvenile justice system with a prior history as victims of child abuse or neglect, an analysis of the services necessary for the prevention and treatment for these youth, and a plan for providing such services.

The legislation also makes meaningful improvements to the core protections that are at the heart of the JJDPA. These improvements include reinforcing the provisions regarding disproportionate minority confinement (DMC) to work with states on specific and intentional steps toward reducing DMC. Similarly in the areas of jail removal, and sight and sound protections, S. 678 strengthens language to further protect youth under the act.

In addition, the bill improves conditions of confinement in juvenile facilities, supports states in providing comprehensive services and supports for youths, and sets more appropriate authorization levels. This legislation represents an essential step forward in reducing recidivism and increasing delinquency prevention.

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House Holds Hearing on Federal Child Nutrition Programs

With a nod to the First Lady's "Let's Move" initiative, the House Committee on Education and Labor held a hearing with experts in child nutrition on Tuesday, March 2, to discuss the Child Nutrition and WIC Reauthorization Act. This act encompasses nine federal programs that ensure millions of low-income children have access to healthy food, particularly in school and child care settings. Chairman George Miller (D-CA) opened the hearing by emphasizing the importance of good nutrition in improving children's physical health, academic success, and self-confidence. He further pointed out the potential for maximizing these programs as "teachable moments" to educate children on the importance of healthy habits, while also noting that the government must involve individuals, families, communities, and the private sector. Ranking member John Kline (R-MN) followed by underlining the importance to appropriately balance federal support and local leadership, and particularly to ensure that parents are able to offer input.

Additional testimony was offered by representatives of the School Nutrition Association, the National Child and Adult Care Food Program Forum, the Public Health Foundation Enterprises, Inc., and the National School Boards Association. The witnesses generally agreed upon the need for increased funding across all of the child nutrition programs, echoing the President's budget proposal for an addition $1 billion for these programs. CWLA recognizes the importance of child nutrition programs as a prevention measure in the effort to ensure the well-being of children.

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Sparks Confirmed for Administration for Native Americans at HHS

Lillian Sparks was unanimously confirmed by the Senate on March 3 as Commissioner of the Administration for Native Americans (ANA). The ANA is under the Administration for Children and Families (ACF) in the Department of Health and Human Services (HHS). It provides resources for self-governance and self-planned, designed, and implemented social and economic development projects that are intended to promote self-sufficiency and cultural preservation of the 562 federally recognized tribes, native organizations, and native populations throughout the Pacific basin. The ANA also takes a lead role in coordinating collaboration and cooperation of native programs and resources within both ACF and HHS, as well as throughout the federal government. Sparks was most recently the executive director of the National Indian Education Association and has a history of working as an attorney on youth issues and health care among others as they relate to Native Americans. HHS Secretary Kathleen Sebelius said "Lillian Sparks will be an outstanding leader," and the Secretary "looks forward to working with her in the months and years ahead."

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Key Upcoming Dates for Congress

March 28-April 11: Spring break for Congress
April 15: Deadline to adopt budget resolution
May 15: House may begin passing regular appropriations bills
July 3: Target date for House to pass all 12 appropriations bills
August 7: Target date for senate to pass all 12 appropriations bills

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